Provider Demographics
NPI:1942023627
Name:SULLIVAN, SHEILA DENISE (DOULA CERTIFICATE)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:DENISE
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:DOULA CERTIFICATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12709 SIGNET AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-3170
Mailing Address - Country:US
Mailing Address - Phone:216-240-8236
Mailing Address - Fax:
Practice Address - Street 1:12709 SIGNET AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-3170
Practice Address - Country:US
Practice Address - Phone:216-240-8236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula